Special Health Resources

Eligibility Specialist

Special Health Resources  •  Texarkana, TX (Onsite)  •  2 months ago
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Job Description

Job Location: Texarkana, TX 75501
Position Type: Full TimePOSITION SUMMARY
The Eligibility Specialist and ADAP Enrollment Worker position has general office duties and serves as a support person to a group of programs. Primary responsibilities are typically; meet with all potential new enrollees for the AIDS Drug Assistance Program (i.e. the Texas HIV Medication Program or THMP); explain THMP program benefits and requirements; and assist clients with the submission of complete, accurate APAP applications greeting clients by phone and in the clinic, assisting with client appointments, establishing client financial eligibility, verifying insurance, assisting senior programmatic staff in day-to-day operations; assisting in grant compliance; preparing correspondence; inputting information into databases and computerized and written report preparation. Significant responsibilities include answering telephone, scheduling appointments, providing the public general information, taking/delivering messages and providing support to clinical and programmatic staff.
ESSENTIAL RESPONSIBILITIES:
- - Answer patient calls and email
- - Scheduling and conduct patient appointments
- - Establish client financial eligibility
- - Maintain communication with designated THMP staff
- - Submit patient applications
- - Ensure each enrollee’s annual recertification is submitted
- - Proactively contact current THMP enrollees and ensure all necessary documentation is gathered
- - Must document per Texas Department of State Health Services (DSHS) and/or The Houston Regional HIV/AIDS Resource Group (TRG) requirements all activities performed on behalf of THMP enrollees including recertification and semi-annual attestation
- - Communicate with third party billing services, providing documentation as needed
- - Update financial eligibility as needed
- - Assist with regulatory documentation on clinical trials
- - Inventories supplies and maintain inventories, completing purchase requests as needed
- - Provides support to clinical personnel for insurance, Medicaid and Medicare billing
- - Prepares correspondence in a professional style and format
- - Inputs data into databases correctly
- - Schedules patient appointments
- - Maintains effective filing system and files necessary information in a timely manner
- - Has extensive understanding of all services, and is capable of relaying information to the patients
- - Assists direct care staff in scheduling clients and coordinating services
- - Assists supervisor in preparing programmatic reports in an accurate and timely manner
- - Communicates readily with Supervisor, case managers and coordinator assistant on programmatic, agency interpersonal, and significant client information
- - Prepares monthly reports in a timely manner as requested by supervisor
- - Serves as an advocate for the clients
- - Reports any emerging trends or unusual situations to supervisor
- - Facilitates admission into program and/or referral (e.g., inpatients treatment, mental health counseling) to appropriate services to assist client

Qualifications
- Computer and Microsoft Office proficiency required
- Case manager experience preferred
- Strong data/analytics background preferred
Special Health Resources

About Special Health Resources

With locations in Longview, Tyler, Texarkana and Paris, Special Health Resources provides patients throughout East Texas with the highest quality comprehensive care. We treat the whole family, with a wide range of services available.

Our services include:

Adult Primary Care

Pediatric Primary Care

Dental Services for Adults and Children

Women's Health, including Family Planning, OB/GYN, Maternity Services

Men's Health Services

Mental and Behavioral Healthcare

Telehealth Services

Substance Abuse Counseling and Treatment

HIV Testing, Treatment and Prevention

Medication Savings

This entity receives HRSA Health Center Program grant funding under 42 U.S.C § 254b and has been deemed a Public Health Services employee for purposes of certain liability protections, including Federal Tort Claims Act coverage, under 42 U.S.C. 233(g)-(n).

Industry
Healthcare & Social Services
Company Size
51-200 employees
Headquarters
Longview, Texas
Year Founded
Unknown
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